Three elderly people died and 14 were in serious condition after a fire ripped through a Sydney nursing home on Friday in what emergency services called their "worst nightmare".
Hundreds of firefighters, police and paramedics raced to the Quakers Hill Nursing Home in the early hours of the morning after an automatic fire alarm went off, to find a "chaotic and tragic" scene.
"This is a firefighter's worst nightmare -- turning up to a nursing home where there are elderly people who can't get themselves out of harm's way," said New South Wales (NSW) Fire and Rescue commissioner Greg Mullins.
"We had dozens of firefighters in breathing apparatus working in thick black smoke where they couldn't see their hands in front of their faces, so imagine what it was like for the elderly trying to escape."
New South Wales police superintendent Robert Redfern said that three bodies had been found in the smouldering building.
Ambulance officials added that many residents were hurt in the disaster with 14 in intensive care, some with severe burns.
Redfern warned that with the injured so old and frail, the death toll might rise. Earlier reports had suggested up to nine people may have died.
"To the best of my knowledge we have identified all of the people who were in the premises at the time," said the police chief.
"We have saved lives today by the outstanding work of the emergency services," he added, after emergency crews reached the scene within six minutes of the alarm being raised.
Rescuers had to go into the building on hands and knees in acrid smoke to save anyone they could, Mullins said.
"Crews had to literally crawl on their hands and knees into every room in the complex, reach up under the beds, searching cupboards, anywhere where someone may have crawled away," he said.
"So it has taken quite some time because of the thick black smoke to confirm that we had all of the residents cleared."
Dozens of disorientated people were seen lying on beds or sitting in wheelchairs outside the home in the aftermath, some of them being attended to by paramedics.
Around 100 people, some blind or suffering dementia, were evacuated from the building and NSW Ambulance assistant commissioner Mike Willis said the injured were rushed to nine Sydney hospitals.
"It was a chaotic scene that confronted us," he said.
Officials said the fire was believed to have broken out in two areas of the facility, with homicide and arson squad detectives on the scene to investigate the cause, although their job was hampered when parts of the roof collapsed.
Police superintendent Michael Willing, who is leading the case, said it was unclear whether there were any suspicious circumstances, although specially trained dogs scoured the ruins to see if any accelerant was used to start the fire.
"We treat all of these matters as suspicious until we can prove otherwise," he told reporters. "At this point we just don't know what we have on our hands."
Gary Barnier, head of the company that runs the nursing home, said he had spoken to many survivors.
"I can't imagine what it was like for them... they seem to be in as good a spirits as could be under the circumstances," he said, while Minister for Ageing Mark Butler said it was "the sort of event that horrifies a nation".